Board: Drug therapy for children with autism was risky

A doctor nationally known for treating autism with a drug sometimes used to chemically castrate sex offenders has been suspended from practicing medicine in his home state of Maryland after state officials determined he is putting children at risk.

Dr. Mark Geier allegedly misrepresented his credentials, misdiagnosed children and urged parents to approve risky treatments without fully informing them of the potential dangers, according to the Maryland Board of Physicians.

The board's order, dated April 27, states that Geier "endangers autistic children and exploits their parents by administering to the children a treatment protocol that has a known substantial risk of serious harm and which is neither consistent with evidence-based medicine nor generally accepted in the relevant scientific community."

Geier told the Tribune in 2009 that he had treated hundreds of children with a testosterone suppressant called Lupron, which he called a "miracle drug." But a Tribune investigation exposed the therapy as a potentially dangerous treatment based on junk science and promoted by a physician not board-certified in any specialty relevant to autism or the use of hormone-disrupting drugs.

Geier, who has treated Illinois children and retains a license to practice medicine here, is prominent in the world of alternative treatments for autism. His ASD Centers advertise "new hope for autism," and he has offices around the country, including in Springfield. Geier is scheduled to speak at the annual Autism One conference this month in west suburban Lombard.

The Maryland board found that in six of nine cases it reviewed, Geier incorrectly diagnosed children with autism with precocious puberty — that's the extraordinarily early onset of puberty — and prescribed Lupron, which is sometimes covered by insurance to treat that rare condition.

In some cases, according to the board, Geier diagnosed the children with precocious puberty and prescribed drug protocols without examining them or conducting proper tests. Some of the children Geier diagnosed were too old to have the condition.

Geier is a genetic counselor, but according to the Maryland board order he has falsely claimed to be a board-certified geneticist and epidemiologist.

Geier, who is not allowed to practice in Maryland while the case is pending, referred questions to attorney Joseph Schwartz III. At the root of the case, Schwartz said, was a "bona fide dispute over therapy" rather than a doctor who posed an immediate threat to patients.

"If you read the (order), you say, 'Holy God, this is awful.' But if it were so awful, they should have an injured child, and they don't," Schwartz said. "…It's just like shadowboxing with allegations that sound awful, but when you delve into the facts of them you say, 'What's the big deal here?'"

Experts have long doubted the scientific basis for Geier's claims and treatments. In 2009, about two dozen prominent endocrinologists, in a paper published online in the journal Pediatrics, dismissed his Lupron protocol. Experts also warn that Lupron can disrupt normal development and potentially put children's hearts and bones at risk.

The medical board also noted that Geier's son, David, who is not a medical doctor but serves as executive director of ASD Centers, examined a 10-year-old boy in May 2008. David Geier ordered lab tests for him and tried to check his neck and stomach by tapping him with an ultrasound wand as the boy moved around the room, the boy's mother told the board..

A record documenting that visit said the child's "symptoms are compatible with a diagnosis of pervasive developmental delay — not otherwise (specified)," and also noted insomnia and Unspecified Metabolic Disorder.

Maryland Gov. Martin O'Malley appointed David Geier in 2009 to the state's Commission on Autism as a "diagnostician," a decision state officials are reviewing. David Paulson, a spokesman for the state health department, said David Geier declined Wednesday to resign from the position.

The board received three complaints about Mark Geier beginning in 2006. In one case, Geier allegedly diagnosed a 91/2-year-old autistic boy with precocious puberty even though the child was too old to qualify for the diagnosis, failed to perform tests that might have helped make a more accurate diagnosis and misread some of the lab tests he did order.

Geier then started the boy on Lupron and other drugs and ordered risky chelation therapy, which removes heavy metals from the body, even though the child didn't have high levels of metals in his body, according to the board's order.

Geier, the order said, "needlessly exposed (the boy) to the risk of harm because of his incorrect diagnosis."

The medical board also faulted the way Geier claimed to vet his treatment protocols. Federal regulations require that independent boards review research protocols to protect the rights and welfare of research subjects. But the board Geier set up included his wife, his son, David, and himself, according to the order.

This is not the first time Geier's work has been criticized. For years, Geier has testified as an expert witness in court cases in which parents claim vaccines caused their child's autism — an idea that has been widely discredited. In one such case, the judge, or special master, called Geier's testimony "seriously intellectually dishonest."

The board's order is the first step in what often is a lengthy process. At a hearing next week, Geier will be allowed to present evidence; the board also will hear from its own representative. The board can uphold the suspension, allow Geier to practice while it continues to investigate or throw out the order.

Geier, according to the board, is licensed to practice medicine in 10 other states, including Illinois and Indiana. Illinois could suspend Geier's medical license only if the state found "imminent danger" to Illinois patients or if the Maryland board takes permanent action, said Sue Hofer, a spokeswoman for the state department that licenses physicians.